INFRARENAL ABDOMINAL AORTIC ANEURYSM REPAIR TECHNIQUE Russian patent published in 2014 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: distal anastomosis is applied between the peripheral branch of a vascular implant with the iliac or femoral artery on one side. The aneurysmal sac is dissected away between two clips within the neck below the renal arteries. Thrombotic masses are pressed out of the sac by opening the lower clip above the aneurysmal sac. Thereafter, the clip is closed again. The aneurysmal sac is corrugated as much as possible by screwing its walls lengthwise inside with U-sutures applied from above and tightened to bring the walls of the aneurysmal sac together. When tightening the U-sutures above the aneurysmal sac, the clip above it is temporarily opened. The haemostatic U-sutures are further applied on the proximal end of the aneurysmal sac along the whole perimeter. The lower clip above the aneurysmal sac is removed. The proximal anastomosis is formed between the central branch of the vascular implant and the abdominal aorta. The main blood flow is opened along the abdominal aorta through the vascular implant and the first distal anastomosis to the leg and pelvic organs. That is followed by forming the second distal anastomosis between the second peripheral branch of the vascular implant with the iliac or femoral artery on the opposite side. That is followed by restoring the main blood flow to the second leg and pelvic organs.

EFFECT: method enables minimising time of aortic compression; the main blood flow in the abdominal aorta is compressed only for the time of forming the proximal central anastomosis with the vascular implant; during applying the distal anastomoses, the blood flow in the abdominal aorta is opened; the blood flow in the lower extremities is compensated by counterlaterals; an ischemia/reperfusion injury is minimised; a topical and three-dimensional anatomy is recovered within the aneurysmal sac; compression of surrounding organs and tissues is eliminated; the walls of the preserved aneurysmal sac are reinforced.

1 ex, 1 dwg